EMDR is a client-centred approach in which a clinician works with the client to identify the specific problem or problems that will be the focus of treatment. The clinician gathers sufficient information about the client's history and current functioning to develop a clear understanding of current difficulties and a collaborative treatment plan. Information about the EMDR treatment process is provided to permit informed consent to treatment. As part of preparation for working with disturbing material, skills for emotional self-regulation are taught and an EMDR procedure known as Resource Development and Installation (RDI) is offered to enhance current functioning and lessen feelings of fear or vulnerability related to targeting disturbing memories or situations. When the client's current functioning is stable and the client feels well-prepared, treatment then turns to the targeting of disturbing memories or situations. Depending on the presenting complaints, client history and treatment goals, the length of different phases of EMDR treatment will be different for each client.
The original source of EMDR is derived from the work of Francine Shapiro, Ph.D. who developed the approach based on clinical observation, controlled research, feedback from clinicians whom she had trained and previous scholarly and scientific studies of information processing. EMDR is not just a simple technique characterised primarily by the use of eye movements. EMDR is founded on the premise that each person has both an innate tendency to move toward health and wholeness, and the inner capacity to achieve it.
EMDR claims to integrate elements from psychological theories (e.g. affect, attachment, behaviour, bio-informational processing, cognitive, humanistic, family systems, psychodynamic and somatic) and psychotherapies (e.g., body-based, cognitive-behavioural, interpersonal, person-centred, and psychodynamic) into a standardised set of procedures and clinical protocols. It draws on research on how the brain processes information and generates consciousness, and also informs the evolution of EMDR theory and procedure.
The Adaptive Information Processing model, which is the theoretical foundation of the EMDR approach, is based on the following hypotheses:
- Within each person is a physiological information processing system through which new experiences and information are normally processed to an adaptive state.
- Information is stored in memory networks that contain related thoughts, images, emotions, and sensations.
- Memory networks are organised around the earliest related event.
- Traumatic experiences and persistent unmet interpersonal needs during crucial periods in development can produce blockages in the capacity of the adaptive information processing system to resolve distressing or traumatic events.
- When information stored in memory networks related to a distressing or traumatic experience is not fully processed, it gives rise to dysfunctional reactions.
- The result of adaptive processing is learning, relief of emotional distress, and the availability of adaptive responses and understanding.
- Information processing is facilitated by specific types of bilateral sensory stimulation. Alternating, left-right, bilateral eye movements, tones, and kinaesthetic stimulation when combined with the other specific procedural steps used in EMDR enhance information processing.
Specific, focused strategies for stimulating access to stored information (and in some cases, adaptive information) generally need to be combined with bilateral stimulation in order to produce adaptive information processing.
EMDR procedures foster a state of balanced or dual attention between internally accessed information and external bilateral stimulation. In this state the client experiences simultaneously the distressing memory and the present context.
The combination of EMDR procedures and bilateral stimulation results in decreasing the vividness of disturbing memory images and related affect, facilitating access to more adaptive information and forging new associations within and between memory networks.
EMDR uses specific psychotherapeutic procedures to
1) access existing information,
2) introduce new information,
3) facilitate information processing and
4) inhibit accessing of information.
Unique to EMDR are both the specific procedural steps used to access and process information, and the ways in which sensory stimulation is incorporated into well-defined treatment procedures and protocols, which are intended to create states of balanced or dual attention to facilitate information processing.
EMDR is used within an 8-phase approach to trauma treatment in order to insure sufficient client stabilisation and re-evaluation before, during and after the processing of distressing and traumatic memories and associated stimuli.
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